The Portland daily press. [volume] (Portland, Me.) 1862-1921, 1887-07-13
DOCTORS DISAGREE.
Various Opinions Concerning the
New Treatment for Consumption.
PHILADELPHIA Record.l

view treatment Tor consumption.
Philadelphia Recordl
Several interesting papers on the treat
ment Of consumption by gaseous enemata
were read at the meeting of the Association
OF American physicians in Washington last
month. Drs. Z. T. Bruen, w. Pepper and j.
p. Crozier Griffith, of this city, and Drs. f.
q. Shattuck and Henry jackson, Of Boston,
gave the results Of their experiments with
the treatment introduced by DR.. l.. Bergeon,
of Lyons, France. Dr. Bruen, who was the
first to apply the treatment in this country
referred to a previous paper, in which he
gave the results Of about two months use Of
the method upon twenty-five cases in the
Philadelphia Hospital. Continuing he said /:
Since April have been able to follow con-
tinuously fourteen Of the first cases. Out Of
the twenty-five cases two have died. Twelve
cases remain In the same condition in which
they were when | wrote my paper in April
that is to say, the physical signs remain un-
changed; the temperature still above normal /;
the flesh and strength not increased after the
first gain Of, say, an average Of five pounds.
Yet the patients undeniably feel better; the
process Of suppuration, with the attendant
evils, has been modified, suppressed OF con-
trolled, and it must be admitted that the pa
tients have been benefited by the treatment
Since April | have applied the Bergeon
method to twenty-four cases in private prac-
tice, and to thirteen additional hospital
cases, so that in all can present sixty-two
cases in which the treatment has been ap-
piled in a systematic manner.
OF these cases, DIR. Bruen said, f0rty-twO
have been benefited, while fifteen are report
ed as having shown negative results. Among
the fifteen, however, were three cases in
| which the treatment seemed to have a decid-
| edly good effect, but their condition luetu-
ated so much, that, for fairness sake, he
| placed them on the negative list OF the ma
| ture of the results DIR. Bruen said:
| The favorable effects secured by the treat
ment were lessened cough and expectoratiOn
| and disappearance Of the physical signs OF
bronchial catarrh. Together with these re-
suits came lowered temperature and suspen-
| sion OF night sweats, temporary reduction Of
the pulse rate fifteen to twenty beats and
temperature lowered from half a degree to
one degree during administration of the gas
In most of the cases | used the artifcially
prepared sulphur water, viz: five grains Of
sulphide and five grains Of chloride OF sodium
TO pint and half Of water, and this seems
to have been the most satisfactory solution
| After employing the treatment Tor several
| weeks, In some cases L have increased the
| proportions OF the two salts gradually, add
ing seven and half, ten, fifteen and twenty
| grains by weekly additions; but in cases in
| which have failed TO secure good effects
| from the weaker solutions l have derived no
| benefit from increasing the strength of the
| solution. Recently l have used the Sharon
| Spring sulphur water, and adding the sui
| phide and chloride of sodium each day. BY
keeping the bottle tightly corked | have
been able TO use the SaIRe bottle on two con-
secutive days.
In none OF the cases have any injurious eff
fects been observed, but / have noted in
some individuals subnormal temperature
during the use Of the gas, and also when the
stronger solutions of sulphide Of sodium
were used the appetite and strength of the
patients seemed impaired and their spirits
depressed.
Two suggestions may be given for the fail
ure Of the treatment to accomplish better re-
suits. The first of these applies only to hos
pital cases. Ii is impossible in large gen.
eral hospital to secure the detailed attention
TO diet necessary to suit the caprieious appe-
tite of the cOnsumptive. In treating con-
sumption it Is absolutely necessary 10 in
crease the vitality of the tissues. so that they
will be unfavorable culture media for the
bacilli.
The second suggestionis is that in cases with
inherited tendencies to phthisis, or In those
who acquire phthisical tendency, there IS
great vulnerability Of the mucous membranes,
which ever fosters an outbreak Of catarrhal
processes in the bronchial structures. In
this way the good effects Of the treatments
are constantly opposed. l incline to think
that suitable climatic environment is an all
important adjunct TO the proper settlement
Of the value of Bergeon's treatment. But it
Is certainly an important addition TO our
therapeutic equipment to have an agent capa-
BILE OF influencing very markedly bronchial
catarrh in so many cases, especially the stay
at-h0mes.
In word, BergeOns method. as far as
have used it, Is chiefly valuable in those
cases of pulmonary disease attended with
bronchial catarrh. But l fear the trouble
and detail necessary to its successful use will
| prevent many from employing the method,
and can easily see that the limitation Of
| the power Of BergeOn's method will cause 1t
often to be set aside for other plans of treat
ment
| In conclusion, l believe our efforts in the
| therapeusis Of phthsis should always be di-
rected to those measures which tend to es-
| tablish the general health, rather than TO
| hunt up specific forms Of treatment. Suit
| able climatic conditions and judiciOus ali
mentation, and appropriate personal hygiene
| remain, in my opinion, the first principles in
| the therapeutic management Of phthisis, and
| Bergeon's treatment should be considered
| an adjunct TO these.
Drs. Shattuc and jackson reported seven
| cases, and their comment upon the method
was as follows:
The number of our cases is small, but we
| think ourselves justified in drawing the fol-
| lowing conclusions:
/. Toxic symptoms may follow the injec-
tion Of sulphureted hydrogen gas into the
| Teetum, among such symptoms being nausea,
| vomiting, general depression or collapse,
diarrhea and headache.
2. Strong artificial solutions Of sulphur
eted hydrogen, mixedwith carbonic acid and
| injected into the rectum, are apt TO cause alb
| dOminal discomfort; the risk of this il dim
inished by warming the solution Of the for
/ mer gas.
8, This method is in no sense specific
| for phthisis. III useful, 1t is only as an aux
iliary to older and generally accepted meth
| ods.
4. The only benefit which we saw in our
cases that can fairly be attributed to the
enemata was diminution in the amount OF
/ expectOrati0n.
TO these conclusions we should like to add
/ two Impressions:
/. Recorded experience seems to sho
that there is considerable difference in Z :.
ferent ndividuals-and perhaps in the same
/ individual at different times lin the amount
Of sulphureted hydrogen which can be safe
| ly injected into the rectum. A priori rea-
| sOning makes 1t almost incredible that the
amount Of the gas which can be passed
through the lungs when Bergeon's method IS
strictly followed IS large enough to nave any
2. The good effects which have unques-
| ti0nably followed the treatment ON this side
Of water, as well as in France, are perhaps
largely attributable to the stimulus afforded
| by a novel method of treatment, which Is Of
such nature that the patient cannot but
feel that not only something but much is be-
| ing done for him.
| Drs. Pepper and Griffith took an unfavor-
able view Of the treatment. Their summary
| of thirty-f0ur cases was as follows:
Febrile temperature was sometimes low
cred, but never to any great extent. Cough
and expectorati0n were occasionally les
sened, but oftener unaffected, and sometimes
even increased. Weight was Oftener lost OF
stationary, but decided gain was frequent
ly made, due, perhaps partly TO the gas, and
no doubt to the improved conditions of life.
| DyspnPa and night sweats were rarely bene'
| hted. the physical signs were in no case al
tered, the general health was but seldom
made better, and severe collie was a frequent
and annoying symptom. Our conclusions
so far as they can be formulated in pre-
liminary report of comparatively few case:
are: That the treatment of phthisis by
gaseous enemata has had very undue value
I attributed to it. that it is seldom Of any rea